Introduction – The prevalence of type 2 diabetes (T2D) is particularly high in France’s overseas departments and regions (DROM), and chronic complications are more common there. The objective of our study was to examine the specific characteristics of the DROMs regarding the demographic and socioeconomic characteristics, health status, and healthcare utilization of individuals with type 2 diabetes residing in four DROMs: Martinique, Guadeloupe, French Guiana, and Réunion. Methods – For the Entred 3 study, a random sample of 12,772 adults receiving pharmacological treatment for diabetes was selected from health insurance databases in September 2019, including 3,700 residing in the DROMs. The study population was restricted to individuals with T2D, identified using an epidemiological algorithm. Data were collected via a face-to-face questionnaire. Their physicians were invited to complete a supplementary questionnaire. Data from the National Health Data System (SNDS) were extracted for participants and non-participants, allowing for the calculation of weights by territory that incorporated the sampling plan and non-response to the questionnaires. The estimates were weighted. Comparative tests between the DROMs and among the five regions including mainland France were performed after adjusting for sex and age. Results – The study population included 498 people in Guadeloupe, 682 in Martinique, 504 in French Guiana, 586 in Réunion, and 2,714 in mainland France. A female predominance was observed in the DROMs compared to mainland France. Residents of French Guiana and Réunion were younger (61 and 63 years on average) compared to the Antilles and mainland France (67 and 68 years). The age at diagnosis of T2D was also approximately 5 years younger in these two territories. Socioeconomic status was lower in the DROMs, and the proportion of people born abroad was highest in French Guiana (53%). The average body mass index (BMI) was lower in Réunion (27.7 kg/m²), French Guiana, and Guadeloupe (28.4 kg/m²) than in Martinique (29.3 kg/m²) and mainland France (29.5 kg/m²). Alcohol and tobacco use was less common in the DROMs compared to mainland France, with the exception of higher smoking rates in Réunion (14%). The average HbA1c (glycated hemoglobin) level was higher in the DROMs compared to mainland France (7.4%, 7.5%, 8.0%, and 7.7%, respectively, in Guadeloupe, Martinique, French Guiana, and Réunion vs. 7.2%). The frequency of chronic complications was higher in Réunion, regardless of the specific complication. Only the frequency of podiatric and renal complications did not vary significantly across the territories. Conclusion – When considered within a cultural, social, and health context, these results will help policymakers adapt public policies regarding prevention, support, and care for people with type 2 diabetes in the overseas territories.